CN-370000-LE706-4I-63402.pdf

This Work Authorization Form is issued by the Florida Department of Environmental Protection, Office of Emergency Response, and authorizes work to be performed by Clif Berry Inc. under Contract LE706. The authorization is designated for emergency response services at US 19 N / 64 Av N in Pinellas Park, Pinellas County, Florida. The incident reference is DEP Incident #2016-463402, dated July 1, 2019, with Jeff Tobergle designated as the responsible OSC (On-Scene Coordinator).

The work involves the disposal of abandoned waste, specifically the transport of one overpack drum containing approximately 20 gallons of hydraulic oil to CBI/Tampa by OER/Tampa personnel. The fixed price contract is not to exceed $1,700.00 for waste profiling and routine used oil screening conducted by the contractor. The work assignment utilizes a field chemist at EPA Level 1 and Level 2 personal protective equipment (PPE) work clothes at Level D. Funding is allocated from Project LE706 using Organization Code 3109010000, EO FC, Object Code 1399000, and Fund 0910001 under Category 10/1992. The work authorization was approved on July 2, 2019, with approvals from DEP Representative Jeff Tobergle, Contractor Representative Nicole Collins, and OER Budget Representative Alex Escober.